Figure 1. Four steps in the mental models approach …...in implementing the mental models approach to risk communication to promote private well testing. In June, mental models surveys

Figure 1. Four steps in the mental models approach to risk

Study Report

August 15, 2018

Improving Stewardship of Private Groundwater Wells Evidence-Based Approaches for State and Local Agencies

Dr. Jacqueline MacDonald Gibson

Prior studies have shown that private well owners rarely, if ever, test the quality of their drinking water.1 As a result, households relying on private wells may be exposed to drinking water contaminants without being aware of these exposures and the need for preventive action. This project’s overall objective is to develop evidence-based risk communication materials that NC local health departments can use to encourage private well owners to test their water quality on a routine basis.

As the basis for risk communication design, we are using the Mental Model Models Approach to Risk Communication. This approach posits that risk communications intended to promote health-protective behavior should correct common misperceptions and reinforce correct knowledge of the target audience, emphasizing perceptions and knowledge most associated with the target behavior. The approach has four steps (Figure 1). We completed step 1 and the first part of step 2 (semi-structured interviews) in prior research. With NC Policy Collaboratory funding, we are completing steps 3-4, along with additional tasks toward promoting private well water quality testing. Specifically, our objectives were to

1. Using a mental models survey, determine beliefs driving decisions to test private groundwater wells.

2. On the basis of the beliefs identified in Objective 1, design and pilot test risk communication materials encouraging private well owners to test their water. Conduct a randomized controlled trial of the risk communication to determine its effectiveness in promoting private well testing.

3. Evaluate the role of cost in decisions to test private groundwater wells by offering free water tests to a subset of recipients of the mental models risk communication and a control group.

4. Provide decision support to the NC Division of Public Health and local health departments on use of the risk communication materials.

Results of each objective are reported here.

1

Figure 2. Latent variables predicting whether or not a survey

Objective 1: Determine Beliefs Driving Decisions Survey Administration

We administered a mental models survey developed in our prior research to 115 private well owners in Wake County, NC. The survey instrument included 276 items potentially relevant to private well stewardship behaviors (Appendix 1). Participants were provided with paper copies of the survey, which they completed and returned to the research team by mail or in person.

Survey Analysis

Factor analysis was used to identify latent concepts driving the frequency of private well water testing as reported by survey respondents. Potential factors were identified using exploratory factor analysis, and effects on well testing behavior were assessed via confirmatory factor analysis and structural equation modeling. Results

The factor analysis identified three latent constructs significantly associated with private well testing behavior (Figure 2). We have titled these factors “Sensory Perceptions,” “Knowledge and Urgency,” and “Cost.” Table 1 lists the questions associated with each factor.

From Table 1, the Sensory Perceptions factor represents beliefs about whether contaminants can be detected through sight, smell, or taste—or through long-term consumption of the water without noticing any problems. The Knowledge and Urgency factor represents knowledge about where and how to test water, along with a sense that testing should be prioritized. The cost factor represents concerns about the cost of treatment, should contamination be detected; the cost of testing; and beliefs that water should be free or low cost.

As Figure 2 illustrates, the Sensory Perceptions factor influences whether or not well owners test their water on its own and also as mediated by knowledge about testing and a sense of urgency. Knowledge and a sense of urgency, along with concerns about cost, influence testing behavior directly. As Table 2 indicates, the less the perception that water contaminants can be detected by sensory perception, the more likely the well owner is to test their water. Similarly, well owners with more

2

knowledge about how to test and a greater sense of urgency about testing are more likely to test their water than those with less knowledge and a lower sense of urgency. Those concerned about costs are much less likely to test their water than well owners not concerned about the potential high costs of treatment interventions and testing.

Table 1. Observed questionnaire responses associated with latent variables SurveyItem

Details Loading on Factor

Factor 1: Sensory Perceptions Q7 Water looks, smells, and tastes fine, so there is no need to test 0.97 Q9 No need to test, because water looks, smells, and tastes clean 0.94 Q8 No need to test, because I’ve been using the water for years without

problems 0.90

Factor 2: Knowledge + Urgency Question Details Loading on

Factor Q13 Don’t know where to test 0.853 Q14 Don’t know how to test 0.847 Q15 Don’t know what to test for 0.870 Q18 Wouldn’t know what to do if failed test 0.797 Q12 No time to test 0.611 Q11 Plan to test but haven’t gotten around to it. 0.597 Factor 3: Cost Q21 Can’t afford to fix my well water if chemical contaminants are found 0.851 Q20 Can’t afford to fix my well water if bacterial contaminants are found 0.910 Q16 Can’t afford to test my water 0.824 Q174 Would install a water filter if I could afford it 0.622 Q172 Would prefer city water if it were free 0.586 Q173 Well water is free 0.520

Table 2. Influence of latent variables on frequency of private well water testing Odds ratio for time since last water test

Concept 1 year 2 years 3 years 5 years 10 years Sensory perceptions 6.03** 2.81*** 2.61*** 2.61*** 3.03*** Knowledge + urgency 1.80*** 1.85** 1.86*** 1.92*** 3.04*** Cost 0.369** 0.437*** 0.588** 0.609** 0.607**

Objective 2: Randomized-Controlled Trial Communication Design

We designed a risk communication to correct the misperceptions and fill knowledge gaps identified under Objective 1. The content was designed specifically and exclusively to address the factors identified in the survey analysis as the strongest predictors of whether someone has tested their well water: Sensory Perceptions, Knowledge Plus Urgency, and Costs. Our aim was to make the communication short and direct, focusing on the key factors identified and not including other information, even what may seem like helpful, common sense details (like how wells can get contaminated and how contamination influences health).

3

Box 1. Risk Communication Mailer

Time to Test Your Well! You cannot see lead in well water. You cannot smell arsenic in well water. You cannot taste bacteria in well water.

Be confident your water quality is good.

Call today: 919-707-5910

Has it been more than a year since you tested your well water?

It’s time!

For any questions about this mailer, contact Dr. Jacqueline MacDonald Gibson at [email protected].

We chose a mail-out, over-sized post card to deliver this content. In the survey, a mailer was one of the top choices for people to receive well testing information. Pilot tests with five private well owners in the target population were conducted to compare different mailer formats (tri-fold brochure, single-page insert, over-sized post card) and to evaluate the comprehensibility of proposed text. The over-sized post card format was favored. Pilot testing also results in minor textual modifications.

4

Box 1 shows the final mailer. The design is intended to spark enough interest to read the post card, rather than throwing it away unseen. In selecting a final layout, costs and ease of printing also were considered. The final design can be easily adopted and used by county health departments or other organizations looking to increase well testing, with only a small area that would need to be customized for different users. It could also be included with other mailers, like county tax bills, which was another top choice for receiving information, according to our surveys. Randomized Controlled Trial

To evaluate the effectiveness of the risk communication, the mailer was sent to a random sample of 1,086 private well owners in the extraterritorial jurisdictions of municipalities in Wake and Gaston counties in late June, 2018. On August 14, 2018, a survey was mailed to the 1,086 well owners who received the post cards and to an equal number of matched households not receiving the communication. The survey (see Appendix 2) asked when the recipient last tested their well water and when they plan to test it next. The survey also included questions to measure respondents’ perceptions and knowledge related to the three factors determined to significantly influence well testing behaviors (as shown in Figure 2). Further details about the randomized-controlled trial design are described under “Objective 3.”

Once surveys are received, they will be analyzed to determine the effects of the risk communication on (1) water testing rates, (2) perceptions of water quality, and (3) knowledge of how to get water tested. Survey results will be reported in an addendum to this document by December 2018.

Objective 3: Role of Cost

Our factor analysis (Figure 2) demonstrated that concerns about cost significantly decrease private well testing. To further elucidate the role of cost, our randomized controlled trial included conditions in which private well owners were offered a free water test (Table 3). In brief, half of 1,086 private well owners receiving the risk communication and half of those in the matched control group received on offer of a free well water test. The above-mentioned survey results will be used to analyze the role of cost, with and without the risk communication, in decisions to test private well water quality. These results will be provided with the aforementioned report addendum.

Table 3. Randomized-controlled trial design

Financial Intervention Behavioral (Risk Communication) Intervention

No Risk Communication Risk Communication

No Free Water Test Group 1 (control), n=543 Group 2, n=543

Free Water Test Group 3, n=543 Group 4, n=543

Objective 4: Decision Support

We are already supporting the NC Division of Public Health and county health departments in implementing the mental models approach to risk communication to promote private well testing. In June, mental models surveys were mailed to 3,000 private well owners in Union, Jackson, and Currituck counties in collaboration with the Division of Public Health and the local health departments. The results will be used to determine whether modifications are needed to the post card to reflect local perceptions and knowledge. The results will be used to develop guidance to

5

local health departments on use of the mental models risk communication. Details will be provided in the December 2018 report addendum.

References

(1) Malecki, K. M. C.; Schultz, A. A.; Severtson, D. J.; Anderson, H. A.; VanDerslice, J. A. Private-well stewardship among a general population based sample of private well-owners. Sci. Total Environ. 2017, 601–602, 1533–1543.

(2) Bruine de Bruin, W.; Bostrom, A. Assessing what to address in science communication. Proc. Natl. Acad. Sci. U. S. A. 2013, 110 Suppl, 14062–14068.

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Appendix 1

u

u

u

u

Dr. Jacqueline MacDonald Gibson UNC Gillings School of Global Public Health Campus Box 7431 Chapel Hill, NC 27599-7400

Questions About Your Water Dr. Jacqueline MacDonald Gibson is a professor in the Gillings School of Public Health at the University of North Carolina, Chapel Hill. She is studying what people think of their well water quality and how they maintain their wells. Dr. Gibson wrote the survey questions you see here. Your answers are very important to her research. We greatly appreciate your help.

This survey is being sent to 1,000 people in Wake County who own or use a private well for their water supply. If you have any questions, please write to Dr. Gibson at [email protected] or at the address above.

The first 200 people to mail back completed surveys will receive a $15 Starbucks gift card by mail. If your survey is postmarked by January 6, 2017, you will be entered into a drawing to win a free iPad. The winner will be drawn at random from all surveys completed and postmarked by January 6.

The survey will take 20-25 minutes to complete. When you’re finished, please mail the survey back in the provided postage-paid envelope. Your answers are confidential. Nobody other than Dr. Gibson’s research team will see them.

Thank you very much for your help. If you are not sure what to answer, please give us your best guess.

1. Where You Get Your Water

YES NOu Does your water come from a private well?

If you answered “NO,” you do not need to finish the rest of the survey.

u About how old is your well? YEARS

2. Where You Get the Water You Use for Drinking and Cooking

For the next two questions, please fill in a number from 0 to 100 and make sure the two numbers add up to a total of 100 percent.

u How much of the water you drink at home comes from your well? PERCENT

(a number from 0 to 100)

u How much of the water you drink at home comes from bottled water? PERCENT


1

mailto:[email protected]

u

u

u

u

u

u

u

u

Just like you did for the previous two questions, for the next two questions please fill in a number from 0 to 100 and make sure the two numbers add up to 100 percent.

u How much of the water that you cook with at home comes from your well?

u How much of the water that you cook with at home comes from bottled water?

3. Your Opinions About Testing Your Well Water

PERCENT


PERCENT


Below are some statements about well water testing. We’d like to know how much you disagree or agree. Please check the box that is closest to your beliefs. If you are not sure, please give us your best guess.

u As long as my well water looks, tastes, and smells good, I do not need to test it for contamination.

u My well water does not need to be tested because I’ve been drinking it for years without problems.

u My well water does not need to be tested because it looks clear, has no smell, and tastes clean.

u Public health experts recommend testing well water every year.

u I plan to test my well water but haven’t gotten around to it yet.

u I don’t have time to get my well water tested.

COMPLETELY SOMEWHAT NEITHER SOMEWHAT COMPLETELY DISAGREE DISAGREE AGREE NOR AGREE AGREE

DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE

2

u

u

u

u

u

u

u

u

u

u I don’t know where to get my well water tested.

u I don’t know how to get my well water tested.

u I don’t know what to test my well water for.

u I can’t afford the cost of testing my well water.

u I would test my well water if the test were free.

u I wouldn’t know what to do if my well water were tested and found to be contaminated.

u I don’t test my well water because there’s nothing anyone can do to get rid of contaminants in my water.

u I couldn’t afford to fix my well water if it were tested and found to be contaminated with bacteria.

u I couldn’t afford to fix my well water if it were tested and found to be contaminated with chemicals.


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE

QUESTIONS ABOUT YOUR WATER: A UNIVERSITY OF NORTH CAROLINA STUDY 3

u

u

u

u

u

u

u

u

u

u

u

u I am concerned that a bad water test result might cause the value of my property to decrease.

u I haven’t tested my well water because I forgot.

u If I test my water, I understand what the water test results I get back mean.

u I’m afraid of asking the health department to test my well water because they would force me out of my home if they found a problem.

u I don’t trust the government to test my well water.


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE

Below is a list of organizations that test well water. Please indicate whether or not you would trust each organization to test your well water.

u I would trust the Wake County Department of Public Health to test my well water.

u I would trust the North Carolina Division of Public Health to test my well water.

u I would trust a local university (for example, N.C. Central, N.C. State, UNC, or Duke) to test my well water.

u I would trust a nonprofit, nongovernment organization (for example, Clean Water for North Carolina) to test my well water.

u I would trust a private lab to test my well water.

u I would trust a water treatment company (for example, Sears, Culligan, etc.) to test my well water.

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

4

u

u

u

u

4. Testing Your Well Water

Below are questions about tests of your well water. For each question, please give us your best guess, even if you are not sure.

YES NOu Has your well ever been tested?

u If you have tested your well, about how long ago was it?

u When your well was last tested, what was it tested for? If you don’t remember, please check “not sure.”

Bacteria

Lead

Copper

Nitrate/nitrite

Arsenic

Iron/manganese

Pesticides/herbicides

Volatile organic compounds

Gross alpha radiation

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

u Have any of these contaminants been found in your water?

Bacteria

Lead

Copper

Nitrate/nitrite

Arsenic

Iron/manganese




YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

NOT SURE

YEARS

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE


Below are statements about the chance that your well could contain different pollutants. For each, please check the box that is closest to your beliefs about whether your well could be contaminated.

u My well water may be contaminated with bacteria.

u My well water may be contaminated with lead.

u My well water may be contaminated with copper.

u My well water may be contaminated with nitrate and/or nitrite.

u My well water may be contaminated with arsenic.

u My well water may be contaminated with iron and/or manganese.

u My well water may be contaminated with pesticides and/or herbicides.

u My well water may be contaminated with volatile organic compounds.

u My well water may be contaminated with gross alpha radiation

YES NO MAYBE

YES NO MAYBE

YES NO MAYBE

YES NO MAYBE

YES NO MAYBE

YES NO MAYBE

YES NO MAYBE

YES NO MAYBE

YES NO MAYBE

I DON’T KNOW WHAT

BACTERIA ARE

I DON’T KNOW WHAT

LEAD IS

I DON’T KNOW WHAT

COPPER IS

I DON’T KNOW WHAT

NITRATE AND/OR

NITRITE IS

I DON’T KNOW WHAT

ARSENIC IS

I DON’T KNOW WHAT

IRON AND/OR

MANGANESE ARE

I DON’T KNOW WHAT

PESTICIDES AND/OR

HERBICIDES ARE

I DON’T KNOW WHAT

VOLATILE ORGANIC

COMPOUNDS ARE

I DON’T KNOW WHAT

GROSS ALPHA

RADIATION IS

These questions ask about different tests for well water and the cost of the tests.

u Imagine it has been a few years since you last tested your well. Would you would be willing to pay for these tests?

Bacteria: $25

Inorganic chemicals (nitrates, lead, arsenic, copper, iron, etc.): $50

Pesticides: $50

Herbicides: $50

Volatile organic chemicals: $50

Radon: $50

Gross alpha radiation: $50

Package including bacteria, inorganic chemicals, volatile organic compounds, pesticides, and herbicides: $275

YES

YES

YES

YES

YES

YES

YES

YES

u

u

u

u

u

u

u

u

u

u

NO

NO

NO

NO

NO

NO

NO

NO

6

u

u

u

u If you have tested your water before, where did you have it tested?

Wake County Department of Public Health YES NO

YES NOCertified private laboratory

Water treatment company (Sears, Culligan, etc.) YES NO

Local city water company YES NO

YES NOOther (please explain):

We are interested in your opinions about where to get information about well water testing and safety.

u Where do you go to get information about water testing and water safety?

Internet search

North Carolina Division of Public Health

Wake County Department of Public Health

Water treatment company (Sears, Culligan, etc.)

Local city water company

Friend or family member

Neighbors

Religious or community organization

Local university or college

Professional well driller

Plumber

Other (please explain):

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

YES NO

u Which approach is the BEST way to provide information about well water testing? Please indicate your top three choices using the numbers 1 through 3.

Postcards

Wake County tax bills

Door hangers

Real estate agents informing clients

Social media (Facebook or Twitter)

Government websites

Religious or community organizations

Water treatment company (Sears, Culligan, etc.)

Your doctor’s office



5. Maintaining Your Well

u When was the last time you hired a YEARS AGO NEVER

professional to inspect your well for cracks, holes, corrosion, and other problems?

(how many?)

u When was the last time you personally YEARS AGO NEVER

inspected your well for cracks, holes, corrosion, and other problems?

(how many?)

u If you have previously tested your well water and learned it was contaminated, what did you do to address the contamination?

u

u

u

u

u

Nothing

Disinfected the well

Installed whole-house water treatment system

Installed under-sink water filter

Began using a Brita or other commercial brand filter

Used bottled water instead of well water

I have never tested my well water.

Other (please specify):

u If you had a question about your private water well, where would you go for an answer? Please rank the three most likely sources of information with “1” being the most likely source, “2” being the second most likely, and “3” being the third most likely.

Friend or family member

Local or state department of environmental protection

Water testing laboratory

Internet search

Water treatment vendor

Professional well driller

Plumber


6. Treating Your Water

u Do you have any water treatment equipment in your home? YES NO

If “NO,” please skip to Section 7.

8

u

u

u

u If “YES,” what type of treatment equipment do you have?

Water softener

Iron filter

Sediment filter

Carbon filter

UV disinfection

Constant chlorination

Reverse osmosis


YES

YES

YES

YES

YES

YES

YES

YES

NO

NO

NO

NO

NO

NO

NO

NO

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

u What contaminants does your treatment system remove?

Bacteria

Lead

Copper

Nitrate/nitrite

Arsenic

Iron/manganese





YES

YES

YES

YES

YES

YES

YES

YES

YES

YES

NO

NO

NO

NO

NO

NO

NO

NO

NO

NO

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

NOT SURE

u If you shock chlorinate your well, which of these contaminants are removed?

Bacteria

Lead

Copper

Nitrate/nitrite

Arsenic

Iron/manganese





YES NO NOT SURE

YES NO NOT SURE

YES NO NOT SURE

YES NO NOT SURE

YES NO NOT SURE

YES NO NOT SURE

YES NO NOT SURE

YES NO NOT SURE

YES NO NOT SURE

YES NO NOT SURE


u

u

u

u

u

u

u

u

u Why do you have water treatment equipment?

It was already installed when I purchased the home.

Water tests indicated that I needed treatment equipment.

There was an obvious taste, odor, or staining problem.

It was difficult to rinse off soap.


u About how much did your equipment cost, including installation? $

u How often is your water treatment equipment maintained?

MORE THAN ONCE A YEAR

7. Your Preferences for a Water Source

ONCE A YEAR

DON’T KNOW

EVERY FEW YEARS NEVER

Below are some statements about different sources of drinking water, from well water to city water to bottled water. Please check a box for each statement to let us know how much you agree or disagree.

u Overall, I have enjoyed having well water.

u If I had the choice, I would prefer to drink water from a city water system.

u Even if I could get access to city water, I would prefer to drink my well water.

u I prefer well water to city water because well water is cheaper.

u I would prefer to drink bottled water.


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE

10

u

u

u

u

u

u

u

u

u

u

u I prefer well water to city water because I fear that city

COMPLETELY SOMEWHAT NEITHER SOMEWHAT COMPLETELYwater could be contaminated DISAGREE DISAGREE AGREE NOR AGREE AGREE

by a terrorist attack. DISAGREE

u I prefer drinking well water to city water because city water

COMPLETELY SOMEWHAT NEITHER SOMEWHAT COMPLETELYtastes like chlorine. DISAGREE DISAGREE AGREE NOR AGREE AGREE

DISAGREE

u I prefer drinking well water to city water because I have

COMPLETELY SOMEWHAT NEITHER SOMEWHAT COMPLETELYcontrol of my water. DISAGREE DISAGREE AGREE NOR AGREE AGREE

DISAGREE

u I prefer drinking well water to city water because well water

COMPLETELY SOMEWHAT NEITHER SOMEWHAT COMPLETELYis more natural. DISAGREE DISAGREE AGREE NOR AGREE AGREE

DISAGREE

u I prefer drinking well water to city water because the city puts

COMPLETELY SOMEWHAT NEITHER SOMEWHAT COMPLETELYchemicals in the water. DISAGREE DISAGREE AGREE NOR AGREE AGREE

DISAGREE

u City water is safer than my well water.


DISAGREE

u I would not be able to afford water bills from the city.


DISAGREE

8. Costs of Water

u How much do you spend every year to maintain your well? $

u How much would you be willing to pay each year to have $ city water instead of well water? I WOULD NOT USE CITY WATER

EVEN IF IT WERE FREE.

u If you don’t have a home water filter now, how much $ would you be willing to pay to buy and install a home filter? I WOULD NOT USE A HOME WATER

FILTER EVEN IF IT WERE FREE.


u

u

u

u

u

u

u

Below are some additional statements about the costs of water. Please check a box for each statement.

u I prefer well water to city water because I don’t want to pay a water bill. COMPLETELY

DISAGREE SOMEWHAT

DISAGREE NEITHER

AGREE NOR SOMEWHAT

AGREE COMPLETELY

AGREE DISAGREE

u I would prefer to drink city water if it were free.


DISAGREE

u Getting water from a well is free.


DISAGREE

u I would install a home water filter if I could afford it.


DISAGREE

9. The Quality of Your Drinking Water

Please rate the quality of your well water in comparison with city water.

u The quality of your well water

VERY POOR SOMEWHAT NEITHER SOMEWHAT VERY GOOD POOR GOOD NOR GOOD

POOR

u The quality of city water

VERY POOR SOMEWHAT NEITHER SOMEWHAT VERY GOOD POOR GOOD NOR GOOD

POOR

Below are some statements about the quality of your well water. Please check a box for each statement to let us know how much you agree or disagree.

u I really like the taste of water from my well.


DISAGREE

12

u

u

u

u

u

u

u

u

u Sometimes my well water tastes funny.


DISAGREE

u Sometimes my well water looks funny.


DISAGREE

u Sometimes my well water smells funny.


DISAGREE

u My water leaves a reddish stain or slime in my toilet, my

COMPLETELY SOMEWHAT NEITHER SOMEWHAT COMPLETELYlaundry, or other fixtures. DISAGREE DISAGREE AGREE NOR AGREE AGREE

DISAGREE

u My water has a sulfur (rotten egg) smell.


DISAGREE

u I am worried about the quality of my well water.


DISAGREE

u If my well water were contaminated, there are ways

COMPLETELY SOMEWHAT NEITHER SOMEWHAT COMPLETELYto clean the water using filters DISAGREE DISAGREE AGREE NOR AGREE AGREE

or other methods. DISAGREE

10. Water and Your Health

Below are some statements about your water and health. Please check a box for each statement to let us know how much you agree or disagree.

u My well water is safe to drink.


DISAGREE


u

u

u

u

u

u

u

u

u If my septic system fails, it could contaminate my

COMPLETELY SOMEWHAT NEITHER SOMEWHAT COMPLETELYwell water and make me or DISAGREE DISAGREE AGREE NOR AGREE AGREE

someone in my family sick. DISAGREE

u I am worried about possible health problems caused by

COMPLETELY SOMEWHAT NEITHER SOMEWHAT COMPLETELYcontamination of my well DISAGREE DISAGREE AGREE NOR AGREE AGREE

water. DISAGREE

u I have been sick before from contamination of my well

COMPLETELY SOMEWHAT NEITHER SOMEWHAT COMPLETELYwater. DISAGREE DISAGREE AGREE NOR AGREE AGREE

DISAGREE

u Someone in my family has been sick before from

COMPLETELY SOMEWHAT NEITHER SOMEWHAT COMPLETELYcontamination of my well DISAGREE DISAGREE AGREE NOR AGREE AGREE

water. DISAGREE

u I would feel comfortable allowing a baby to drink water

COMPLETELY SOMEWHAT NEITHER SOMEWHAT COMPLETELYfrom my well. DISAGREE DISAGREE AGREE NOR AGREE AGREE

DISAGREE

11. Sources of Pollution in Drinking Water Wells

Below are some statements about possible sources of well water contamination. Please check a box for each statement to let us know how much you agree or disagree.

u My septic system is a possible source of well water

COMPLETELY SOMEWHAT NEITHER SOMEWHAT COMPLETELYcontamination. DISAGREE DISAGREE AGREE NOR AGREE AGREE

DISAGREE

u My neighbors’ septic systems are a possible source of well

COMPLETELY SOMEWHAT NEITHER SOMEWHAT COMPLETELYwater contamination. DISAGREE DISAGREE AGREE NOR AGREE AGREE

DISAGREE

u Corrosion of the parts of my well is a possible source of well

COMPLETELY SOMEWHAT NEITHER SOMEWHAT COMPLETELYwater contamination. DISAGREE DISAGREE AGREE NOR AGREE AGREE

DISAGREE

14

u

u

u

u

u

u

u

u

u

u Corrosion of my household plumbing pipes or fixtures is a possible source of well water contamination.

u Wastes (for example, containers of oil) left in my yard are a possible source of well water contamination.

u Nearby oil or natural gas wells (fracking) are a possible source of well water contamination.

u Nearby landfills are a possible source of well water contamination.

u Nearby industrial facilities (for example, the power company) are a possible source of well water contamination.

u Roads and highways are a possible source of well water contamination.

u Nearby mining activities are a possible source of well water contamination.

u Nearby farms are a possible source of well water contamination.

u Nearby commercial development (for example, new housing construction) is a possible source of well water contamination.


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE


u

u

u

u

u

u

u

12. Amount of Water You Get from Your Well

u My well sometimes fails to provide enough water:

More than once a year

Once a year

Once every years (please fill in)

Never

u What do you give up when your well fails to provide enough water?

(please fill in)

u In the past, my well has not provided enough water because of:

YES NOFreezing

YES NOPump failure

Power failure YES NO

YES NOLeaking pipe

Dry weather or drought YES NO

YES NOOther (please explain):

13. Sewage Disposal in Your Home

u Does your home have a septic system? YES NO

If you answered “NO,” please skip ahead to Section 14.

u Has your septic system ever overflowed into your yard or home? YES NO

u About how old is your septic system?

Less than one year 11 to 20 years

One to three years More than 20 years

Four to 10 years

u How often do you have your septic system pumped out?

EVERY YEARS NEVER

(how many?) NOT SURE

16

u

u

u

u

u

u

Below are some statements about septic systems. Please check a box for each statement to let us know how much you agree or disagree.

u My septic system is currently causing problems.

u My septic system has had problems in the past.

u A bad odor is the best way to know that a septic system needs to be pumped.

u Failed septic systems can cause sewage to overflow in the yard.

u Failed septic systems can cause sewage to overflow in the home.

u Failed septic systems can contaminate my well water.


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE


u

u

u

u

u

u

u

u

14. Questions About You

u Have you participated a UNC study of well water before? YES NO

u What is your sex? MALE FEMALE

u How old are you? YEARS

u How many people live in your household?

u How old are the other people in your household?

u Would you describe yourself as:

American Indian / Native American

Black / African American

Asian / Asian American

Hispanic / Latino

White / Caucasian


Prefer not to answer

u Which of the following types of housing units best describes your home?

Single-family detached house

Single-family attached house (row house)

Apartment building with two to four units

Apartment building with five or more units

Mobile home


u Do you rent or own your home?

Rent

Own


18

u

u

u

u

u

u

u How long have you lived in your home? YEARS

u How old is your home? YEARS

u If you currently have a cell phone, can you YES NO DON’T HAVE

receive text messages? A CELL PHONE

u Do you currently have access to the internet at home?

Yes, only on my phone

Yes, only on my computer

Yes, on my phone and my computer

No

u What is the highest level of education you have completed?

Less than high school

High school / GED

Some college

Two-year or technical college (associate’s degree)

Four-year college (bachelor’s degree)

Graduate school (master’s, J.D., M.D., or Ph.D.)

u What is the total income of all the adults in your home?

Less than $15,000

$15,000–$29,999

$30,000–$49,999

$50,000–$74,999

$75,000–$99,999

$100,000–$124,999

$125,000–$149,999

$150,000–$174,999

$175,000 or more

This is the end of the survey. Thank you very much for your time and your responses. Please see the next page for details on how to return the survey to us and enter the drawing for an iPad.


Returning Your Survey

Thank you again for your participation in this survey, which will greatly help our research on well water quality. Please return the survey in the postage-paid envelope provided. If you are one of the first 200 people to respond, you will receive a $15 Starbucks gift card by mail within two weeks of sending back your survey.

Entering the Drawing for an iPad

To be entered into a drawing to win an iPad, your completed survey must be postmarked by January 6. A winner will be drawn at random on January 17, 2017, from all eligible completed surveys. The winner will be contacted by mail. Please provide your name and mailing address below so that we can contact you if you are the winner. Your name and mailing address will not be used for any other purpose without your permission.

If you do not want to be entered into the iPad drawing and do not wish to receive a $15 Starbucks gift card, you do not need to provide your contact information.

YES, ENTER ME INTO THE DRAWING!

NAME

STREET ADDRESS

STREET ADDRESS LINE 2

, NC CITY ZIP CODE

May we contact you about your survey if we have any follow-up questions?

YES NO

Please return this survey to:


20

Appendix 2


Questions About Your Water This survey was created by Dr. Jacqueline MacDonald Gibson, a professor in the Gillings School of Public Health at the University of North Carolina, Chapel Hill. Your answers are very important to our research and will be used to help inform residents about their wells. Anyone who completes a survey by August 22nd, 2018, will receive a $15 gift card by mail. The survey will take 5-10 minutes to complete. Your answers are confidential. Nobody other than Dr. Gibson’s research team will see them.

This survey is being sent to 2,232 people in Wake and Gaston counties who use a private well for their water supply. If you have any questions, please write to Dr. Gibson at [email protected] or at the address above. Although there are no foreseeable risks to completing the survey, some questions may be uncomfortable to answer. Although you may choose not to respond to any question, each one is important to our research. When you're finished, please return to us in person or mail the survey back in the provided postage-paid envelope.

Thank you very much for your help. If you are not sure what to answer, please give us your best guess.

1. Do You Have A Private Well

u

u

u

NOYESu Does your water come from a private well?

If you answered “No,” you do not need to finish the rest of the survey.

2. Testing Your Well Water

Below are questions about tests of your well water. For each question, please give us your best guess, even if you are not sure.

NOYES NOT SUREu Has your well been tested since June 11th?

u What is the age of your well?

1

mailto:[email protected]

u

u

u If you tested your well since June 11th, what was it tested for? If you don’t remember, please check “not sure.”

Bacteria

Lead

Copper

Nitrate/nitrite

Arsenic

Iron/manganese




YES

YES

YES

YES

YES

YES

YES

YES

YES

NO NOT SURE

NO NOT SURE

NO NOT SURE

NO NOT SURE

NO NOT SURE

NO NOT SURE

NO NOT SURE

NO NOT SURE

NO NOT SURE

u Why didn't you test your well since June 11th? (Choose all that apply) Skip this question if you tested your well.

My well water tastes, looks and smells fine

Cost of well testing

Cost of maintenance if a problem exists

No time to test

Did not know how to test

Did not know where to test

Did not know what to do if I failed a test

Didn't test because I recently tested my well

2

u

u

u Do you still intend to test your well in the future?

YES NO

u When do you plan to test your well water next?

u

u

u

u

u

u

u In your next test, what do you plan to test for? If you don’t know, please check “not sure.”

Bacteria

Lead

Copper

Nitrate/nitrite

Arsenic

Iron/manganese




YES NO NOT SURE

YES NO NOT SURE

YES NO NOT SURE

YES NO NOT SURE

YES NO NOT SURE

YES NO NOT SURE

YES NO NOT SURE

YES NO NOT SURE

YES NO NOT SURE

3. Your Opinions About Testing Your Well Water

Below are some statements about well water testing. We’d like to know how much you disagree or agree. Please check the box that is closest to your beliefs. If you are not sure, please give us your best guess.

u As long as my well water looks, tastes, and smells good, I do not need to test it for contamination.

My well water does not needuto be tested because I’ve been drinking it for years without problems.

My well water does not needu to be tested because it looks

clear, has no smell, and tastes clean.

u I plan to test my well water but haven't gotten around to it yet.

u I don't have time to get my well water tested.


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE


Below are some

u

u

u

u

u

u

u

u

u

u

u I don’t know where to get my well water tested.

u I don’t know how to get my well water tested.

u I don’t know what to test my well water for.

u I can’t afford the cost of testing my well water.

u I wouldn’t know what to do if my well water were tested and found to be contaminated.

u I couldn’t afford to fix my

well water if it were tested and found to be contaminated with bacteria.

u I couldn’t afford to fix my

well water if it were tested and found to be contaminated with chemicals.

u I would prefer to drink city water if it were free.

u Getting water from a well is free.

u I would install a home water filter if I could afford it.


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE


DISAGREE

4

u

u

u

u

u

u

u

4. Where You Get the Water You Use for Drinking and Cooking

For the next two questions, please fill in a number from 0 to 100 and make sure the two numbers add up to a total of 100 percent.

u How much of the water you drink at home comes from your well? PERCENT


u How much of the water you drink at home comes from bottled water? PERCENT


Just like you did for the previous two questions, for the next two questions please fill in a number from 0 to 100 and make sure the two numbers add up to 100 percent.

u How much of the water that you cook with at home comes from your PERCENT

well? (a number from 0 to 100)

u How much of the water that you cook with at home comes from PERCENT

bottled water? (a number from 0 to 100)

5. Did you receive a postcard in the mail

u Do you remember receiving a postcard asking you to test your water?

YES NO

u Who sent you the postcard?

University of North Carolina at Chapel Hill

County Government

Private Water Company

I do not know/ I do not remember

u What was the message of the postcard?

Everybody does it

It's time to test your well

Test your well to protect your health

I do not remember


u

u

u

u

u

u

u

u How many postcards did you receive?

6. Questions About You

u What is your sex? MALE FEMALE

u Would you describe yourself as:

American Indian / Native American

Black / African American

Asian / Asian American

Hispanic / Latino

White / Caucasian


Prefer not to answer

u Do you rent or own your home?

Rent

Own


u How old is your home? YEARS

u What is the highest level of education you have completed?

Less than high school

High school / GED

Some college

Two-year or technical college (associate’s degree)

Four-year college (bachelor’s degree)

Graduate school (master’s, J.D., M.D., or Ph.D.)

u What is the total income of all the adults in your home?

Less than $15,000

$15,000–$29,999

$30,000–$49,999

$50,000–$74,999

$75,000–$99,999

$100,000–$124,999

$125,000–$149,999

$150,000–$174,999

$175,000 or more

This is the end of the survey. Thank you very much for your time and your responses. Please see the next page for details on how to return the survey to us and receive your gift card. 6

Returning Your Survey

Thank you again for your participation in this survey, which will greatly help our research on well water quality. Please return the survey in the postage-paid envelope provided. The first 150 people to complete the survey by August 22nd, 2018 will receive a $15 gift card by mail within 30 days of sending back your survey.

Please fill out your address information to be used only to send your gift card.

NAME

STREET ADDRESS

STREET ADDRESS LINE 2

, NC CITY ZIP CODE

May we contact you about your survey if we have any follow-up questions?

YES NO

Preferred contact number and/ or email:____________________________________________________________

Please return this survey to:



Documents

Figure 1. Four steps in the mental models approach …...in implementing the mental models approach to risk communication to promote private well testing. In June, mental models surveys